声辐射力脉冲成像技术评估肝移植术后缺血型胆道病变的临床应用价值  

Clinical evaluation of liver stiffness by acoustic radiation force impulse imaging in patient with ischemic type biliary lesion after orthotopic liver transplantation

作　　者：徐清华[1] 罗渝昆[1] 唐文博[1] 宋青[1] 焦子育[1] 段伟东[2] 吕发勤[1] 唐杰[1] 

机构地区：[1]解放军总医院超声科,北京100853 [2]解放军总医院肝胆外科,北京100853

出　　处：《中华医学超声杂志（电子版）》2014年第2期26-29,共4页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：国家自然科学基金资助项目(No.81271588)

摘　　要：目的探讨声辐射力脉冲成像(ARFI)技术评估肝移植术后缺血型胆道病变(ITBL)的临床应用价值。方法选择2012年7月至2013年1月解放军总医院肝移植术后复查患者41例,其中15例超声诊断为ITBL。对所有患者进行常规超声检查,并采用ARFI技术测量检测深度为4、5 cm的肝脏剪切波速度(SWV)值,同时检查患者肝功能。采用独立样本t检验比较ITBL患者与非ITBL患者同一检测深度SWV值差异;采用配对样本t检验比较同一ITBL患者不同检测深度SWV值差异。采用Pearson相关分析分别分析所有患者不同检测深度SWV值与肝功能指标的相关性。结果 ITBL患者、非ITBL患者检测深度为4 cm时SWV值分别为(1.561±0.425)、(1.121±0.160)m/s,差异有统计学意义(t=-3.173,P=0.01);检测深度为5 cm时SWV值分别为(1.608±0.545)、(1.175±0.173)m/s,差异也有统计学意义(t=-2.454,P=0.034)。同一ITBL患者不同检测深度SWV值差异无统计学意义。所有患者不同检测深度SWV值均与碱性磷酸酶浓度相关(r值分别为0.656、0.667,P值均为0.000);同时均与γ-谷酰转肽酶浓度相关(r=0.482,P=0.007;r=0.508,P=0.004)。结论 ARFI技术对肝移植术后ITBL评估有一定的临床应用价值。Objective To study the clinical value of acoustic radiation force impulse imaging （ARFI） in patients with ischemic type biliary lesion （ITBL） after orthotopic liver transplantation. Methods Between July 2012 to January 2013, forty-one patients in General Hospital of the People＇s Liberation Army were enrolled in this study who were admitted for post-transplantati0n follow-up. Among them, 15 patients were diagnosed as ITBL by ultrasonography. Besides ＇conventional ultrasonography, ARFI was used to detect the shear wave velocity （SWV） of liver tissue at depth of 4 cm and 5 cm respectively. Simultaneously liver function test was performed. Independent-samples t test was performed to compare the difference of SWV between ITBL and non-ITBL group at the same depth. Paired-sample t test was performed to compare the difference of SWV for the same ITBL patient. Pearson correlation analysis was used in analyzing the relation between SWV and liver function. Results The average SWV in depth of 4 cm was （1.561± 0.425） m/s and （1.121± 0.160） m/s in ITBL and non-ITBL group, respectively. Significant differences were found among the ITBL and non-ITBL groups （t=3.173, P=0.01）. The average SWV in depth of 5 cm was （1.608± 0.545） m/s and （1.175_ 0.173） m/s in ITBL and non-ITBL group, respectively. Significant differences were found among the ITBL and non-ITBL groups （t=-2.454, P=-0.034）. There was no significant difference between SWV measurements at different depth for the same ITBL patient. For all patients, SWV at different depths were both slrongly correlated with alkaline phosphatase （r=0.656, 0.667, respectively; both P=0.000） and γ-glutamyl transpeptidase （r=0.482, P=0.007; r=0.508,P=-0.004）. Conclusion The liver stiffness measurement is valuable for the clinical evaluation of post-transplantation ITBL.

关 键 词：弹性成像技术 肝移植 手术后并发症 

分 类 号：R445.1[医药卫生—影像医学与核医学]